Collins Sara R, Glied Sherry A, Jackson Adlan
Commonwealth Fund.
Robert F. Wagner Graduate School of Public Service at New York University.
Issue Brief (Commonw Fund). 2018 Oct 1;2018:1-11.
With encouragement from the Trump administration, 14 states have received approval for or are pursuing work requirements for nondisabled Medicaid beneficiaries. The requirements have sparked controversy, including two legal challenges.
To predict the effect of work requirements on the insurance coverage of Medicaid enrollees over time.
Analysis of the coverage patterns of a national cohort of nondisabled adults in the federal Medical Expenditure Panel Survey. Their experience is applied to a similar cohort of adults in Kentucky (which has received approval for work requirements, subject to a legal challenge) to project the potential effects of work requirements on their insurance coverage.
Adding a new administrative hurdle in the form of work requirements in Kentucky would double the number of enrollees who disenroll from the program over a two-year period. We estimate that as many as 118,000 adults enrolled in Medicaid would either become uninsured for an extended period of time or experience a gap in insurance over a two-year period. These findings should be of concern to policymakers: research has found that adults who experience coverage gaps report problems getting health care or paying medical bills at rates nearly as high as those who are uninsured continuously.
在特朗普政府的鼓励下，14个州已获批或正在推行针对非残疾医疗补助受益人的工作要求。这些要求引发了争议，包括两项法律挑战。
预测工作要求随时间推移对医疗补助参保者保险覆盖情况的影响。
对联邦医疗支出小组调查中一个全国性非残疾成年人队列的覆盖模式进行分析。将他们的经历应用于肯塔基州一个类似的成年人群体（该州已获批工作要求，但面临法律挑战），以预测工作要求对其保险覆盖情况的潜在影响。
在肯塔基州以工作要求的形式增加一个新的行政障碍，将使在两年内退出该计划的参保者数量翻倍。我们估计，多达11.8万名参加医疗补助的成年人在两年内要么会在很长一段时间内失去保险，要么会经历保险缺口。这些发现应引起政策制定者的关注：研究发现，经历保险缺口的成年人报告在获得医疗保健或支付医疗账单方面存在问题的比例，几乎与持续无保险的成年人一样高。
